国际流行病学传染病学杂志
國際流行病學傳染病學雜誌
국제류행병학전염병학잡지
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY AND INFECTIOUS DISEASE
2012年
6期
378-381
,共4页
肝炎,乙型,慢性%阿德福韦酯片%IFN α-1b%联合治疗
肝炎,乙型,慢性%阿德福韋酯片%IFN α-1b%聯閤治療
간염,을형,만성%아덕복위지편%IFN α-1b%연합치료
Hepatitis B,chronic%Adefovir dipivoxil%IFN α-1b%Combination treatment
目的 探讨阿德福韦酯(ADV)联合IFN α-1b治疗HBeAg阳性慢性乙型肝炎(CHB)患者临床疗效.方法 将120例患者分成3组:单用IFN α-1b组(A组)40例,单用ADV组(B组)40例,ADV和IFN α-1b联合治疗组(C组)40例,疗程48周,分别于治疗12周、24周和48周时查ALT复常率、HBeAg血清转换率、HBV DNA阴转率.其中各组中10人于治疗前及治疗48周行肝穿刺活检术,观察病理改变,根据炎症活动度(G)和纤维化程度(S)进行计分,同时采用纤维化半定量计分系统(SSS)评分.结果 C组24周和48周后的ALT复常率分别为65.0％和87.5％,HBeAg转换率为35.0％和45.0％,HBV DNA阴转率为75.5％和92.5％,均显著高于A组和B组(ALT复常率,24周:x2=7.93、4.81,48周:x2=6.52、3.98,P均＜0.05；HBeAg转换率,24周:x2=4.18、12.26,48周:x2 =4.95、14.58,P均＜0.01；HBV DNA转阴率,24周:x2=9.78、3.75,48周:x2=11.96、6.99,P均＜0.05).组织学肝纤维化各项评分结果联合治疗组均优于单药组,差异有统计学意义(SSS:t=23.27、48.99;G:t=53.89、94.31；S:t =60.01、82.06,P均＜0.01).结论 IFN联合ADV治疗CHB患者可协同抑制HBV复制,明显提高抗HBV疗效,且无明显不良反应,是一种有效的治疗方法.
目的 探討阿德福韋酯(ADV)聯閤IFN α-1b治療HBeAg暘性慢性乙型肝炎(CHB)患者臨床療效.方法 將120例患者分成3組:單用IFN α-1b組(A組)40例,單用ADV組(B組)40例,ADV和IFN α-1b聯閤治療組(C組)40例,療程48週,分彆于治療12週、24週和48週時查ALT複常率、HBeAg血清轉換率、HBV DNA陰轉率.其中各組中10人于治療前及治療48週行肝穿刺活檢術,觀察病理改變,根據炎癥活動度(G)和纖維化程度(S)進行計分,同時採用纖維化半定量計分繫統(SSS)評分.結果 C組24週和48週後的ALT複常率分彆為65.0％和87.5％,HBeAg轉換率為35.0％和45.0％,HBV DNA陰轉率為75.5％和92.5％,均顯著高于A組和B組(ALT複常率,24週:x2=7.93、4.81,48週:x2=6.52、3.98,P均＜0.05；HBeAg轉換率,24週:x2=4.18、12.26,48週:x2 =4.95、14.58,P均＜0.01；HBV DNA轉陰率,24週:x2=9.78、3.75,48週:x2=11.96、6.99,P均＜0.05).組織學肝纖維化各項評分結果聯閤治療組均優于單藥組,差異有統計學意義(SSS:t=23.27、48.99;G:t=53.89、94.31；S:t =60.01、82.06,P均＜0.01).結論 IFN聯閤ADV治療CHB患者可協同抑製HBV複製,明顯提高抗HBV療效,且無明顯不良反應,是一種有效的治療方法.
목적 탐토아덕복위지(ADV)연합IFN α-1b치료HBeAg양성만성을형간염(CHB)환자림상료효.방법 장120례환자분성3조:단용IFN α-1b조(A조)40례,단용ADV조(B조)40례,ADV화IFN α-1b연합치료조(C조)40례,료정48주,분별우치료12주、24주화48주시사ALT복상솔、HBeAg혈청전환솔、HBV DNA음전솔.기중각조중10인우치료전급치료48주행간천자활검술,관찰병리개변,근거염증활동도(G)화섬유화정도(S)진행계분,동시채용섬유화반정량계분계통(SSS)평분.결과 C조24주화48주후적ALT복상솔분별위65.0％화87.5％,HBeAg전환솔위35.0％화45.0％,HBV DNA음전솔위75.5％화92.5％,균현저고우A조화B조(ALT복상솔,24주:x2=7.93、4.81,48주:x2=6.52、3.98,P균＜0.05；HBeAg전환솔,24주:x2=4.18、12.26,48주:x2 =4.95、14.58,P균＜0.01；HBV DNA전음솔,24주:x2=9.78、3.75,48주:x2=11.96、6.99,P균＜0.05).조직학간섬유화각항평분결과연합치료조균우우단약조,차이유통계학의의(SSS:t=23.27、48.99;G:t=53.89、94.31；S:t =60.01、82.06,P균＜0.01).결론 IFN연합ADV치료CHB환자가협동억제HBV복제,명현제고항HBV료효,차무명현불량반응,시일충유효적치료방법.
Objective To explore the treatment efficiency of adefovir dipivoxil (ADV) combined with interferonα-1b (IFN α-1b) in HBeAg positive chronic hepatitis B(CHB) patients.Methods A total of 120 patients were divided into three groups:40 patients treated with IFN α-1b (group A); 40 patients treated with ADV (group B); 40 patients treated with ADV and IFN α-1b (group C).Indicators of ALT,HBeAg and HBV DNA were detected respectively after treatment of 12,24 and 48 weeks.The pathological changes of 10 patients in each group were analyzed by liver puncture biopsy before treatment and after 48-week treatment.The inflammation activity (G) and liver fibrosis stages (S) of these patients were evaluated.The degree of hepatic fibrosis was analyzed by Chevallier's histological semiquantitative scoring system(SSS).Results After treatment of 24 and 48 weeks,the ALT normalized rates of group C were 65.0％ and 87.5％,HBeAg seroconversion rates were 35.0％ and 45.0％,HBV DNA negative conversion rates were 75.5％ and 92.5％,respectively.These data of group C were significantly higher than group A and B (ALT normalized rates,in week 24:x2 =7.93,4.81,in week 48:x2 =6.52,3.98,P ＜ 0.05; HBeAg seroconversion rates,in week 24:x2 =4.18,12.26,in week 48:x2 =4.95,14.58,P ＜0.01; HBV DNA negative conversion rates,in week 24:x2 =9.78,3.75,in week 48:x2=11.96,6.99,P＜0.05).The histological improvement of group C also showed statistically significant difference with the other two groups(SSS:t =23.27,48.99;G:t =53.89,94.31 ;S:t =60.01,82.06,P＜0.01).Conclusions The application of IFN α-1b combined with ADV can inhibit virus replication and improve CHB treatment efficacy without obvious adverse reaction.
